Drug addiction is a chronic, progressive disease that knows no bounds. It ravages the lives of people of every age, race and socioeconomic status and contributes to the death of more than 100,000 Americans every year. According to the National Institute on Drug Abuse, “Everybody knows someone who has been affected by drug abuse.”

Dr. Kathryn A. Cunningham, director of UTMB’s Center for Addiction Research (CAR), says that because of the stigma attached to drug abuse, society is reluctant to confront addiction in the same way we do other diseases. “Addiction is a huge social problem,” she says. “Alcohol is the third leading killer, but nobody wants to talk about it. If we were making the same gains in the treatment of cancer [as we are in treating addiction], we’d be on the front page of the New York Times.”

According to the National Institute on Drug Abuse, the nature of addiction has been a controversial topic for many years. When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society's responses to drug abuse, treating it as a personal failing rather than a health problem. But thanks to continued scientific research, many misconceptions about the disease are being replaced with knowledge and medical breakthroughs.

“Today, thanks to science, our views and our responses to drug abuse have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond effectively to the problem,” said Nora D. Volkow, director of the National Institute on Drug Abuse. “We know that addiction is a disease that affects both brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease.”

Making a difference

UTMB’s Center for Addiction Research is devoted to supporting discovery and translational research to understand addictive processes and design targeted ways to prevent, diagnose and treat the disease of addiction.

Formed in 2004, the center comprises 55 scientists and health care providers from all four UTMB schools. Its mission is to capitalize on cutting-edge technology in areas such as molecular biology, biochemistry and pharmacology in an effort to diagnose, cure or alleviate addiction and its medical complications.

A major step in that direction was the formation of the CAR endowment fund, established last year, to expand the understanding of addiction through research and educational endeavors. The fund was created by three local families who have lost loved ones to the disease of addiction and who hope to see a significant impact made in the field.

“Our family lost a bright, enchanting, big-hearted, hard-working, dare-devil son and brother when Arran died just shy of his 26th birthday. One of the ways we chose to honor his memory was to contribute to the important work taking place in the field of addiction research here at UTMB,” said Christine Comer, UTMB’s vice president for public affairs.

Estimates of the total overall costs of substance abuse in the United States, including health- and crime-related costs as well as lost productivity, exceed half a trillion dollars annually. This includes approximately $181 billion due to illicit drugs, $168 billion attributable to tobacco and $185 billion due to alcohol. As staggering as these numbers are, they do not fully capture the serious implications, such as family disintegration, loss of employment, failure in school, domestic violence and child abuse, or public health and safety.

The CAR is currently taking applications for the 2010 Endowment Award from current students, postdoctoral fellows and junior faculty at universities in the Houston and Galveston areas who are dedicated to expanding the understanding of addiction and its related psychiatric disorders.

One of last year’s recipients, Dr. Noelle Anastasio, received the Arran Thomas Amadeo Streppa Endowment Fund Award based on her translational addiction research in the laboratory of UTMB’s Dr. Kenneth Johnson and her commitment to educating the community about the disease. Anastasio illustrated possible mechanisms underlying the hallucinogenic, psychotic and neurotoxic properites of PCP (angel dust). She was also instrumental in presenting a drug addiction lecture series to local high school and middle school students on the toxic effects of drug use on the brain. She currently works as an addiction scientist focusing on characterizing individual phenotypes of resistance and vulnerability to drug addiction.

“It was an honor to be recognized with the endowment last year,” said Anastasio. “It provided additional motivation and encouragement as I began my career as an addiction scientist.”

Anastasio encourages future endowment applicants interested in pursuing a career in research “to be open to new ideas and collaborations and to be truly vested in pursuing a translational course to further the development of treatment for addiction.”

Adriane dela Cruz, a student in UTMB’s M.D./Ph.D. combined program, received the Frances Adoue Lynch Addiction Research Endowment Award for her research advances, as well as her dedication as a mentor and tutor to fellow students and residential patients at a local addiction rehabilitation center. She identified new brain systems that may underlie cravings in ex-addicts during abstinence. This information provides guideposts to develop new therapeutic approaches to addiction.  The 2009 endowment award is helping her complete her medical school training. She is currently in her third year and is focused on pursuing her residency in psychiatry, with a goal of becoming board-certified in addiction medicine and conducting translational research in this area.

She credits her community service as the catalyst that helped make her endowment application strong, and she stresses the importance of educating others on the disease of addiction.

“I really enjoyed the opportunity to speak to community groups, ranging from 4th-graders to women in residential treatment for addiction,” said dela Cruz. “I think it’s imperative that scientists share their knowledge, and I hope I have the opportunity to speak during my residency and as part of my career.”

She believes one of the most challenging aspects of addiction is to educate society on the realities of the disease.

“Many people don’t understand that addiction is a chronic disease. Having an addiction is not a person’s fault, just like having type 2 diabetes isn’t the patient’s fault. And while many people do make the choice to use a substance, only a small fraction develop full-blown addiction, and that propensity is partially dependent on a patient’s genetic background,” said dela Cruz.

The focus of dela Cruz’s dissertation research involved the role that environmental stimuli can play in prompting a drug relapse.

“The return to a drug isn’t always under conscious control,” said dela Cruz. “It is often more like a habit. A major goal of research into treatment for addictions is to develop medications that can interrupt this process, so that environmental stimuli don’t lead a person to return to taking drugs.”

Sue J. Davis received the 2009 CAR Achievement Endowment Award for her tireless efforts at the Gulf Coast Center WomenSpirit Program in Galveston to promote knowledge of addiction locally and throughout Texas. Davis is the program director of the Substance Abuse Recovery Programs at the center and a licensed social worker and chemical dependency counselor. She also serves as president of the Coalition of Coastal Texas Association of Substance Abuse Programs, where she promotes substance abuse prevention and treatment as well as research.

“Partnership with CAR and other local agencies that serve our target population and address addiction is one strategy for extending access to prevention and treatment.  My advice to future endowment recipients and applicants is to value and honor their community partners in this work,” said Davis.  “None of us can do this alone, and the Gulf Coast Center and UTMB have a rich history of working with one another and other entities within the community to maximize the public dollar. What we lack as a community in funding, we make up for in care, concern and commitment.” 

The CAR’s endowment fund is working to expand the understanding of addiction through supporting those dedicated to the research and treatment of the disease. For more information on how to apply or to read more about the CAR, visit http://www.utmb.edu/addiction/index.htm.